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General NPI Number Information
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NPI Number | 1760771067
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Entity Type | Individual
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Provider Name | KRISTAL ANGUIANO PA
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2010 INDUSTRIAL PARK RD. EL CENTRO FAMILY HEALTH
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City | ESPANOLA
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State | NM
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Zip | 87532-3600
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Country | US
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Telephone | 505-753-7395
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 158 EL CENTRO FAMILY HEALTH
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City | ESPANOLA
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State | NM
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Zip | 87532-0158
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Country | US
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Telephone | 505-753-7218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09117
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License Number State | TX
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